Wednesday, February 7, 2018

Delivering the Babies

(This post is actually a chapter from a book I am writing on my career as a Labor & Delivery nurse.  I will post these from time to time and I hope you enjoy them.)

Chapter 22
Delivering the Babies

Looking back over the almost forty years I have worked with mothers having babies, I have been honored to be present in over three-thousand deliveries. . .and still counting!  On many occasions, I have been the one to deliver the baby.  I wish at the onset of my Labor & Delivery career I had started counting how many babies I have actually delivered and now I give that advice to each new nurse coming into our unit.  It saddens me that the birth of any baby would escape my memory, but I know I will never remember a great number of those little ones whom I have helped ease into this world.

I do, however, remember the first baby I ever delivered, but for reasons much different than you might expect.  I remember it because it was extremely disappointing.

At the university hospital where I first learned obstetrics, the obstetric residents would teach each new nurse how to deliver a baby.   The nurse would gown and glove herself and sit at the end of the delivery table.  The resident would stand behind her and tell her exactly what to do, where to put her hands, how to ease out the baby's head, how to check to see if there was any umbilical cord around the baby's neck -- and what to do if there was -- how to help deliver first the top shoulder, and then the bottom shoulder.  After that the baby would usually just slide out by itself.  They would show us how to hold that slippery, wiggling baby, too, so that it couldn't be dropped!

One night, it was my turn.  I sat at the end of the delivery table looking at a woman I had never met, waiting to deliver her baby.  I went though the motions just as the resident directed me and before I knew it, I was holding a slippery little baby. . .something, I don't even remember now if it was a boy or a girl.  I handed the baby over to the woman's nurse and finished the rest of the work that had to be done during a delivery.  All the while I was surprised I didn't feel as I thought I would.  I had expected to feel excited, elated and thrilled.  After all, I had just delivered a baby and not everyone can do that!  In reality, I felt about as much emotion as if I had picked up a watermelon at the store and put it in my basket.  In fact, I am sure I have felt more emotion over a really good watermelon.

When I got home I told my family about my new accomplishment.  They were thrilled and elated, but I still just felt empty and disappointed.  It took a long time and a lot of deliveries later to realize what was missing.

That first delivery didn't have the significance for me that another one did.

I had been "loaned" to the Information Systems department of our hospital to work on the new computerized documentation system our hospital was implementing.  The project was supposed to last three months, but instead it lasted three years.  For those three years I dealt with computers instead of pregnant women.  I loved the work and had the honor of teaching the new system to almost every nurse in the hospital.  When my part of the project was complete and it was time to come back to Labor and Delivery, I was nervous.  I wondered how much I might have forgotten in those three years.

I asked my Nurse Manager if I could have a brief time of re-orientation and asked her to put one of the experienced nurses with me, just in case there was something I had forgotten that I didn't know I had forgotten.  What I found was I needed a little help remembering how to work the newer pumps and machines, but everything about labor I remembered.

That was proven true when our patient suddenly progressed much faster than we expected.  We called for the doctor to come quickly, but the baby was coming faster than the doctor.  Without hesitation, or even much thought, I reached over to the delivery table for a towel and the bulb syringe.  I had years more experience than the "experienced" nurse with me.  Delivering the baby seemed like the most natural thing in the world for me to do at the time.  It was an easy, smooth delivery and I have always felt like it was the Lord's way of telling me I was right back where He wanted me to be.

Another delivery stands out in my mind because of the actions of the physician.

I was delivering a baby and the mother's physician came in the room about the same time I was delivering the baby's head.

"Come on," I told him, "take it from here."

He surprised me by responding, "No, you're doing a great job.  You do that and I'll do your stuff."

So, I delivered the baby, collected the cord blood and delivered the placenta, while he gave the medications and attended to the baby.  I've often wondered what the mother thought to have her physician act as her nurse and her nurse act as her physician.

When I became Assistant Nurse Manager of our unit, I knew I would be delivering fewer babies because I would be giving less direct patient care.  So I was surprised when one day my skills were called upon.

I was sitting at my desk, which was located almost in the center of the unit, putting me in earshot of each room.  Our newest day shift nurse, not long out of school, came to me rather frantically and said "Call Dr. Robinson!"

"Call her for what, Linda?" because I knew this particular physician would grill me about why she was being called.

"Call her to come!"  Linda sounded exasperated I had asked the question, but I needed more information.

"Why?"  I knew the physician would want to know why she was running down four flights of stairs and across a crosswalk.

"Because the baby's head is right there and she needs to deliver this baby!"  Now that was information I could use, only I couldn't locate Dr. Robinson.  She was not in her office, not on the Postpartum Unit and not in Surgery.  Before I could try another place Linda's urgent voice captured my attention, "Frannie, come here!"

I went to the room and expected to see a baby in the bed, but instead I saw a mother panting and breathing.  I knew this mother from earlier in the day.

When she had come in for her induction her nurse couldn't get her IV started and had asked me to try.  The only vein I had seen had blown as soon as I got into it and I suggested having anesthesia have a look.  I was surprised when I popped my head in a little later and the patient told me that her nurse had looked again and started the IV.  

"She deserves an award!" the patient stated, "She is really great!"  I told her I agreed with her even before Tammy started the IV.

So now here she was ready to have her baby.  I put on a pair of gloves and stood by the side of the bed, but I didn't see the  baby's head crowning.  I decided to stand there just in case, until Dr. Robinson arrived.

Then a particularly strong contraction came and I could see the baby's head slowly begin to emerge.  As the baby's head began to crown, I gently controlled the rate that it delivered.  I was very aware at this point that I not only had the Dad in the room watching everything I did, but also two of our nurses, one of which I was sure had never seen a nurse deliver a baby before.  I wanted her to see it done correctly.

Once the head was delivered, I told the mother not to push while I suctioned the baby's mouth and nose and then felt along the baby's neck for any loop of cord which might have been there.  I was just delivering the rest of the baby when Dr. Robinson came in the room.  She handed me the towel to wipe the baby down.  She clamped the cord and I handed the baby to the mother who was ready to hold her new little girl.

As I walked out of the room, I couldn't pass up the opportunity to remind the mother, "Now Tammy may have started your IV, but don't forget who delivered your baby!"

I did feel excited after this baby and after many, many babies I have delivered.  The difference is being involved with the family, with the mother, and being a part of their experience.  My first delivery I felt like  a robot going through the motions for someone I had never even met.  But almost every other delivery I have done I have had some involvement or relationship with the mother and her family.  There has been some connection, so that the event isn't just delivering a baby, it's delivering joy.  It has been being a part of the creation of a family.

"By Thee have I been holden up from the womb:  
Thou are He that took me out of my mother's bowels:  
my praise shall be continually of Thee."
Psalm 71:6

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